Making everyone happy is impossible. Pissing them off is a piece of cake. I like cake.

Sunday, March 25, 2012

Healthy people are expensive

Anyone follows politics in even the most cursory manner (or, indeed, reads the letters page of the Metro) will, I assume, be thoroughly pissed off with self-righteous fucknuts bollocksing on about how drinkers, smokers and obese people should be taxed to buggery because they cost our brilliant NHS buckets of cash.

For many years, those of us who indulge ourselves in our pleasures have pointed out that we pay a fuck-load of tax for the pleasure of doing so—not just in the ludicrously high National Insurance payments, but also duty on the fags and booze. We pay far more in tax, in fact, than the cost to the NHS.

"Nonsense!" cry the prodnose temperance loons.

Well, now a nice little report has come out which points out that "healthy" people really do cost, as Timmy reports.

The question is, are the costs of treating the illnesses and deaths brought on by those three indulgences higher or lower than the costs of treating those who live healthily but still inevitably die? We could argue it either way: Alzheimer’s costs more to manage than lung cancer costs, the cracked hips of age related osteoporosis perhaps more or less than fried livers from excessive bourbon. What we need to do is actually go and tot up the figures. Fortunately, that has been done:

Obesity is a major cause of morbidity and mortality and is associated with high medical expenditures. It has been suggested that obesity prevention could result in cost savings. The objective of this study was to estimate the annual and lifetime medical costs attributable to obesity, to compare those to similar costs attributable to smoking, and to discuss the implications for prevention.….Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures.

There are excellent arguments in favour of taxing in order to reduce the occurrence of smoking, excessive boozing and obesity. We humans are subject to hyperbolic discounting, not taking full account of long distant future costs for current pleasures, sometimes those running the public health system really do know more than us, there are externalities associated with these behaviours (late night drunks, passive smoking and the visual pollution of someone 300 lbs overweight perhaps). But the argument we cannot use is that these behaviours increase the costs of health care.

The reason we cannot use this argument is that it simply isn’t true.

So all you health fascists can stick that in your pipe and I'll smoke it.

Not included in Timmy's report as the savings in pensions due to shorter life spans. So that would cause a relative increase in the relative financial burden of the healthy lifestyle set.

But there is a particular trend in the UK that we have to bear in mind- the acute illness patients are treated in the NHS for their illnesses. No-one has yet worked out a way of swindling excess medical care fees out of them. Those who stay relatively healthy tend to succumb to the chronic blights of old age, like senile dementia,brittle bones, blindness due to glaucoma, in the last years of their lives. They can thus be charged for their "care" in old people's homes. In fact their assets can be plundered and used to subsidise the state funded patients as well. In fact, they need those self funding patients more and more, everything they own is up for grabs. The more the self-funders are fleeced, the less the state has to pay for the care of those with no assets.Follow the money...